크리글러 나이잘 증후군으로 생긴 신생아 황달 Jaundice caused by Crigler-Najjar syndrome

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크리글러 나이잘 증후군으로 생긴 신생아 황달 Jaundice caused by Crigler-Najjar syndrome

ce1169b1391c5f21013ac73921869580.jpg

그림 273. 췌장과 담즙 분비.

CopyrightⒸ 2011 John Sangwon Lee,MD.,FAAP

  • 크리글러 나이잘 증후군은 유전병이다.
  • 이 병에 1형과 2형이 있다.
  • 빌리루빈 신진대사 효소인 글루쿠로닐 전이효소(Bilirubin UDP-glucuronyl transferase enzyme) 결핍으로 인해 간접형 빌리루빈을 직접형 빌리루빈으로 결합하지 못해 신생아에게 황달이 생길 수 있다.
  • 제 1형은 출생 후 곧 생길 수 있다.
  • 간접형 빌리루빈의 혈 중 농도가 15~35 mg/dl 정도 증가될 수 있고 빌리루빈 뇌병이 생길 수 있고
  • 사춘기기까지 거의 빌리루빈성 뇌병의 후유증이 생기는 것이 보통이다.
  • 교환수혈빌리 광선치료 등으로 치료하지만 완치는 안 된다.
  • 간이식 수술 등으로 치료할 수 있다.
  • 제 2형으로 생기는 신생아 황달은 제 1형으로 생기는 신생 황달의 중증도 보다 훨씬 경미하다.
  • 상염색체 우성으로 유전된다.
  • 신생아가 탈수되면 더 심해 질 수 있다.
  • 페노바르비탈 등으로 치료할 수 있다.

 

Jaundice caused by Crigler-Najjar syndrome 크리글러 나이잘 증후군으로 생긴 신생아 황달

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Figure 273. Pancreas and bile secretion. CopyrightⒸ 2011 John Sangwon Lee, MD., FAAP

• Krigler Nijal syndrome is a hereditary disease.

• There are types 1 and 2 in this bottle.

• Deficiency of the bilirubin metabolic enzyme, glucuronyl transferase enzyme (Bilirubin UDP-glucuronyl transferase enzyme), prevents indirect bilirubin from binding to direct bilirubin, resulting in jaundice in newborns.

• Type 1 can occur soon after birth. • Blood levels of indirect bilirubin may increase by 15-35 mg/dl, and bilirubin encephalopathy may occur.

• It is common to develop sequelae of bilirubin encephalopathy almost until puberty.

• Treatment with exchange blood transfusion and Billy phototherapy, but no cure.

• It can be treated with liver transplant surgery.

• Neonatal jaundice caused by type 2 is much milder than the severity of newborn jaundice caused by type 1.

• Autosomal dominant inherited.

• When a newborn is dehydrated, it can get worse. • It can be treated with phenobarbital.

출처 및 참조 문헌 Sources and references

  • NelsonTextbook of Pediatrics 22ND Ed
  • The Harriet Lane Handbook 22ND Ed
  • Growth and development of the children
  • Red Book 32nd Ed 2021-2024
  • Neonatal Resuscitation, American Academy Pediatrics
  • www.drleepediatrics.com제7권 소아청소년 감염병
  • www.drleepediatrics.com제9권 소아청소년 소화기 질환
  •  Red book 29th-31st edition 2021
  • Nelson Text Book of Pediatrics 19th — 21st Edition
  • The Johns Hopkins Hospital, The Harriet Lane Handbook, 22nd edition
  • Childhood Emergencies in the Office, Hospital and Community, American Academy of Pediatrics
  • Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
  • Emergency care, Harvey grant, and Robert Murray
  • Emergency Care Transportation of Sick and Injured American Academy of Orthopaedic Surgeons
  • Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
  • Immediate care of the acutely ill and injured, Hugh E. Stephenson, Jr
  • The Critically Ill Child, Diagnosis and Management, Edited by Clement A. Smith
  • Emergency Medical Services for Children: The Role of the Primary Care Provider, America Academy of Pediatrics
  • Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
  • Manual of Emergency Care
  • 응급환자관리 정담미디어
  • 소아가정간호백과부모도 반의사가 되어야 한다이상원
  • Neonatal Resuscitation American heart Association
  • Neonatology Jeffrey J.Pomerance, C. Joan Richardson
  • Pediatric Resuscitation Pediatric Clinics of North America, Stephen M. Schexnayder, M.D.
  • Pediatric Critical Care, Pediatric Clinics of North America, James P. Orlowski, M.D.
  • Preparation for Birth. Beverly Savage and Dianna Smith
  • Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
  • The Harriet Lane Handbook 19th Edition
  • 소아과학 대한교과서
  • 1권 소아청소년 응급의료 참조문헌과 출처
  • Other

Copyright ⓒ 2015 John Sangwon Lee, MD., FAAP

부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”